title: Inequalities in asthma treatment among children by country of birth and ancestry: a nationwide study in Denmark.
abstract: BACKGROUND
  Investigations in several Western countries have reported ethnic differences in asthma prevalence and treatment among children and in some countries these differences are increasing. The aim of this study was to analyse whether there are inequalities in asthma treatment by country of birth and ancestry among children residing in Denmark, and whether this potential association may vary between different household income groups.
  
  
  METHODS
  Data were obtained by linking the Danish Civil Registration System, the Central Taxpayers' Register and the Danish National Prescription Register.
  
  
  METHODS
  the entire population of children in Denmark from 0 to 17 years of age in 2008 (n=1 209 091). Information on asthma treatment was obtained from the National Prescription Register. The analyses included multiple logistic regression models stratified by household income.
  
  
  RESULTS
  Compared with ethnic Danes, immigrant children had the lowest OR for redeeming a prescription for asthma medication, both relief (OR 0.37; 95% CIs, 0.20 to 0.68) and preventive (OR 0.37; (0.22 to 0.59)). Similar associations were found among descendant children (OR for relief treatment 0.82 (0.79 to 0.89) and for preventive treatment 0.68 (0.61 to 0.75)). The pattern of the association remained after stratifying for household income.
  
  
  CONCLUSIONS
  We found that, inequalities that cannot be explained by household income alone exist in treatments to prevent asthma as well as to relieve symptoms in children residing in Denmark, by country of birth and ancestry. The difference between immigrants and descendants may indicate that unfamiliarity with the Danish healthcare system is a contributory cause of the inadequate treatment of asthma.
authors.affiliation: Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, , Copenhagen, Denmark.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Cantarero-Arévalo
authors.forename: Bjørn Evald
authors.initials: BE
authors.lastname: Holstein
authors.forename: Anette
authors.initials: A
authors.lastname: Andersen
authors.forename: Susanne
authors.initials: S
authors.lastname: Kaae
authors.forename: Marie
authors.initials: M
authors.lastname: Nørredam
authors.forename: Ebba Holme
authors.initials: EH
authors.lastname: Hansen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000208:ethnology; D003718:Denmark / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D055656:Prescriptions; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D011787:Quality of Health Care; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents
keywords: Access to Hlth Care; Asthma; Child Health; Inequalities; Migration